Innovation in Design

Patient-centred design innovations in urban, regional and community cancer treatment centres are designed to foster optimism and hope, creating new opportunities for better care across Alberta

Michael Civitella, executive director of operations and facility development of the Calgary Cancer Centre. Photograph by Jared Sych.

 

Alberta’s cancer treatment and care facilities continue to evolve and innovate, consulting with patients, staff and other stakeholders to create new opportunities for patient-centred care.

A Place of Healing

For Michael Civitella, careful attention to detail is part of what makes the new Calgary Cancer Centre a special place.

“When you think of a cancer centre, it can have a lot of negative connotations, Civitella says, who is the executive director of operations and facility development for the new centre.

“There were a lot of things in the design we did to try and create a great environment that makes people feel like this is a good place to get healed and looked after.”

Key design features like natural light throughout the facility and exposure to natural elements and exterior surroundings were incorporated throughout the design of the centre, which is projected to open in 2023.

“Traditionally, in hospital facilities, you have one major entrance with a lot of windows and openness, and it’s great,” explains Civitella. “But as soon as you leave that to go to the care areas, or the areas where a lot of the treatments happen, it becomes darker.”

This was a problem that the Calgary Cancer Centre design has solved with the creation of a unique courtyard at the heart of the facility.

“We wanted to make sure that access to natural light and nature comes throughout the building, inside and out,” he says.

Particular attention was also paid to the needs of medical staff during the design process, Civitella adds.

“I think that if you have a staff that is more passionate, more healthy, and feel good about the place, you know that’s going to have a positive impact on the care we provide to the patients,” he says.

While individual design elements — like staff lounges distributed throughout the building and the incorporation of natural light — seem small on their own, Civitella says the overall effect is a hopeful, healthy space of healing.

“I think at the end — and this is my own personal opinion — that’s what will make this cancer facility special.”

Vision and Voice

Charlotte Kessler, an active volunteer with the Calgary Cancer Centre’s Patient & Family Advisory Council, says that incorporating patient voice into the design of the new facility is an essential part of the process.

As a cancer patient herself, Kessler admits that she has experienced inconsistencies in her care since her diagnosis of anaplastic astrocytoma — a rare form of brain cancer — in 2013. These inconsistencies, both good and bad, inspired her to assist in the design of the new Calgary Cancer Centre.

“My initial experiences weren’t great in that I felt very lost in the shuffle,” she explains.

However, she adds that she received “great care” from the Tom Baker Cancer Centre neurological trial team during a later clinical trial.

“I felt like they were giving me patient- centred care, that they were interested in what was happening with me, not just in my diagnosis, not just in what my medical problem was today,” she says. “They cared, and asked, and listened, and engaged.”

From the patient perspective, Kessler, along with other patients and families, has become a passionate advocate for instilling a feeling of hopefulness throughout the new Calgary Cancer Centre.

“We were trying to come up with ways to give [the design team] an end goal — it needs to feel warm, it needs to be welcoming, lighting needs to be adjustable, temperature needs to be adjustable, clean, fresh air, lots of natural light, patient movement, good nutrition and full of hope,” she says.

Kessler says that seeing the patients’ vision for the Calgary Cancer Centre come to life is gratifying, and she is very excited to continue to be part of the facility’s development process ahead of its projected opening in 2023.

“Everything, from the minute you walk in to every moment you’re with your care team … will be just a constant feeling of caring and hope,” she says. “You’re part of the team, not the person being taken care of.”

Rendering of the new Calgary Cancer Centre projected to open in 2023.

Meeting a Local Need

Outside of Calgary and Edmonton, Brenda Hubley is committed to ensuring that Alberta’s cancer patients living in rural and regional centres have access to exceptional care in their local areas.

Hubley, who is the executive director, community oncology and provincial practices with CancerControl Alberta, oversees operations at four regional cancer centres, as well as 11 community cancer centres across the province.

In recent years, she says, patients of these regional cancer centres, which are located in Grande Prairie, Red Deer, Lethbridge and Medicine Hat, as well as patients receiving treatment at community cancer centres, have become increasingly involved in articulating how these spaces can better meet their needs.

“We’ve actually purpose-built them to meet a mid-sized population need and so they have specially built chemotherapy units, they have radiation therapy units, so the exact same type of services with the same quality, with the same infrastructure, basically what you’re needing for safe, quality care, as you’re going to see at a larger site,” she explains. “But from a physical space, they’re smaller.”

One challenge, especially in community treatment facilities, which tend to operate out of smaller, existing buildings, is that these facilities were not purpose-built as community cancer centres.

“Oftentimes when those centres start up, they are based on a local need, a local desire to say, ‘Look, we’ve got a cancer population here and it would be great if they could get their treatment closer to home,’” Hubley says.

“We kind of retrofit them or find a little spot within a hospital, or within a health facility, and create a space,” she says.

While the fundamental framework of a building usually can’t be changed, patient voice is carefully considered as part of the renovation process. For example, Hubley says the regional cancer centre in Lethbridge, the Jack Ady Cancer Centre, was the first of its kind in Alberta to feature a doorless radiation vault — a design feature that has now become standard practice in other treatment facilities across the province.

“It’s not always that the large centre informs the small,” she says. “It can be the other way around, where a design or experience at a smaller centre informs the larger.”

The result, she concludes, is better care for cancer patients across Alberta, and better working environments for staff and patients.

“If an environment is meeting patient needs, it’s going to meet the staff’s needs. If the environment is meeting the staff needs, it’s going to meet patient needs,” says Hubley. “Whenever somebody is more comfortable in that environment and has the ability to deliver on what they need to do, it’s going to meet their needs.”

Small Changes Make a Big Difference

Brenda Hubley, CancerControl Alberta’s executive director of community oncology and provincial practices, shares examples of patient-centred design

Keep Distractions Positive

Patients tend to be more comfortable in a treatment space when they have access to “positive distractions,” Hubley says. “When we position chemo chairs that patients are comfortable in, we give them the ability to have intentional distractions by having TVs or music or designs on the ceilings.”

Let the Light In

“We try to build in the ability for natural light,” she explains. When this is challenging in a retrofitted space, there are other ways to bring in natural elements. “We try to build in spaces and opportunities for calming works of art, the use of natural materials, and feelings of spaciousness.”

Work With The Building

While the fundamental structure of a treatment facility undergoing a renovation can’t change, Hubley says that small adjustments can make a world of difference. “We’ve renovated in Lethbridge, for example, where we have a long hallway,” she says. “There’s no getting around it. But when you create some curves — on the floor, on the wall, and even in the ceiling design — suddenly that hallway doesn’t look as long.

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